PDF(Pubmed)
Abstract：
Penile curvature is the most common abnormality that is observed by men with Peyronie\'s disease (PD). Collagenase Clostridium histolyticum (CCH) has become a standard treatment for PD patients.
To identify predictor factors associated with improvements of penile curvature outcomes in men with PD treated with CCH.
We retrospectively collected the data of patients with PD treated with CCH up to 8 injections divided into 4 cycles between January 2014 and July 2020. Per protocol, penile curvature was assessed at baseline, and after the second and ford CCH cycle. If after cycle 2, curvature demonstrated no improvement, or penile curvature was significantly improved and the patient was happy, no further treatment was recommended. However, if penile curvature was significantly improved and the patient remained dissatisfied, 4 cycles were completed. Three categories of response were evaluated: improvement (≥10 degrees or ≥20%, either 1 happens), unchanged (±10 degrees or ±20%) or worsened (≥10 degrees or ≥20%, either 1 happens). Logistic regression analyses were performed to evaluate predictive factors associated with penile curvature improvements.
Degrees of the curvature changes between the baseline and after the cycles of CCH.
A total of 114 patients underwent CCH treatment. Median age was 57 years. Median PD duration was 11 months. At baseline, mean curvature was 47 degrees, 65% had dorsal curvature, 53% mid-shaft location, and 15% calcification. After CCH treatment, the mean final curvature was 40 degrees. A total of 44% improved the curvature, 39% had no change while 17% worsened after CCH treatment. Of men who had penile curvature improvement with CCH treatment, the mean curvature decreasing in degrees and percentage were 22 degrees and 41%, respectively. Men with baseline curvature ≤ 30, 31-59, and ≥ 60 degrees, the percentage curvature improvement were 29%, 43%, and 60%, respectively. Baseline curvature was the only significant predictor of penile curvature improvement after CCH (OR 1.33, 95% CI = 1.1, 1.7).
We confirmed baseline penile curvature is the most important predictive factor, and this is the first report describing proportions of penile curvature improvement with CCH treatment.
This study has several strengths, including the use of validated instruments. Nonetheless, there are limitations: the retrospective nature of the study, a single institution; and modelling device was not controlled.
Penile curvature improvement was significantly more common in patients with greater baseline curvature, reaching up to 60% for patients with ≥ 60 degrees. Flores JM, Nascimento B, Punjani N, et al. Predictors of Curvature Improvement in Men With Peyronie\'s Disease Treated With Intralesional Collagenase Clostridium Histolyticum. J Sex Med 2022;19:1680-1686.
To identify predictor factors associated with improvements of penile curvature outcomes in men with PD treated with CCH.
We retrospectively collected the data of patients with PD treated with CCH up to 8 injections divided into 4 cycles between January 2014 and July 2020. Per protocol, penile curvature was assessed at baseline, and after the second and ford CCH cycle. If after cycle 2, curvature demonstrated no improvement, or penile curvature was significantly improved and the patient was happy, no further treatment was recommended. However, if penile curvature was significantly improved and the patient remained dissatisfied, 4 cycles were completed. Three categories of response were evaluated: improvement (≥10 degrees or ≥20%, either 1 happens), unchanged (±10 degrees or ±20%) or worsened (≥10 degrees or ≥20%, either 1 happens). Logistic regression analyses were performed to evaluate predictive factors associated with penile curvature improvements.
Degrees of the curvature changes between the baseline and after the cycles of CCH.
A total of 114 patients underwent CCH treatment. Median age was 57 years. Median PD duration was 11 months. At baseline, mean curvature was 47 degrees, 65% had dorsal curvature, 53% mid-shaft location, and 15% calcification. After CCH treatment, the mean final curvature was 40 degrees. A total of 44% improved the curvature, 39% had no change while 17% worsened after CCH treatment. Of men who had penile curvature improvement with CCH treatment, the mean curvature decreasing in degrees and percentage were 22 degrees and 41%, respectively. Men with baseline curvature ≤ 30, 31-59, and ≥ 60 degrees, the percentage curvature improvement were 29%, 43%, and 60%, respectively. Baseline curvature was the only significant predictor of penile curvature improvement after CCH (OR 1.33, 95% CI = 1.1, 1.7).
We confirmed baseline penile curvature is the most important predictive factor, and this is the first report describing proportions of penile curvature improvement with CCH treatment.
This study has several strengths, including the use of validated instruments. Nonetheless, there are limitations: the retrospective nature of the study, a single institution; and modelling device was not controlled.
Penile curvature improvement was significantly more common in patients with greater baseline curvature, reaching up to 60% for patients with ≥ 60 degrees. Flores JM, Nascimento B, Punjani N, et al. Predictors of Curvature Improvement in Men With Peyronie\'s Disease Treated With Intralesional Collagenase Clostridium Histolyticum. J Sex Med 2022;19:1680-1686.
摘要：
阴茎弯曲是佩罗尼病（PD）男性观察到的最常见的异常。胶原酶溶组织梭状芽孢杆菌（CCH）已成为PD患者的标准治疗方法。
确定与使用CCH治疗的PD男性阴茎弯曲结果改善相关的预测因素。
我们回顾性收集了2014年1月至2020年7月期间使用CCH治疗多达8次注射的PD患者的数据，分为4个周期。根据协议，在基线时评估阴茎曲率，在第二个和福特CCH周期之后。如果在第2周期之后，曲率没有改善，或阴茎曲率明显改善，患者很高兴，未建议进一步治疗.然而,如果阴茎曲率明显改善，患者仍然不满意，完成4个周期。评估了三类反应：改善（≥10度或≥20％，1发生)，不变(±10度或±20%)或恶化(≥10度或≥20%,1发生）。进行Logistic回归分析以评估与阴茎曲率改善相关的预测因素。
曲率的程度在基线和CCH循环之后变化。
共有114名患者接受了CCH治疗。年龄中位数为57岁。中位PD持续时间为11个月。在基线,平均曲率为47度，65%有背侧弯曲，53%的中轴位置,和15%的钙化。CCH处理后，平均最终曲率为40度。总共44％的改善了曲率，在CCH治疗后，39%没有变化，而17%恶化。在CCH治疗下阴茎弯曲改善的男性中，平均曲率减小的度数和百分比分别为22度和41%，分别。基线曲率≤30、31-59和≥60度的男性，曲率改善的百分比为29%，43%,60%,分别。基线曲率是CCH后阴茎曲率改善的唯一显著预测因素(OR1.33,95%CI=1.1,1.7)。
我们确认基线阴茎曲率是最重要的预测因素，这是第一份描述CCH治疗阴茎曲率改善比例的报告。
这项研究有几个优点，包括使用经过验证的仪器。尽管如此，有局限性：研究的回顾性性质，一个单一的机构；建模设备没有受到控制。
阴茎曲率改善在基线曲率较大的患者中更为常见，对于≥60度的患者，最高可达60%。FloresJM,纳西门托B,旁遮尼N,etal.皮罗尼病患者体内胶原酶组织溶梭菌治疗的曲率改善的预测因子。JSexMed2022；19：1680-1686。
确定与使用CCH治疗的PD男性阴茎弯曲结果改善相关的预测因素。
我们回顾性收集了2014年1月至2020年7月期间使用CCH治疗多达8次注射的PD患者的数据，分为4个周期。根据协议，在基线时评估阴茎曲率，在第二个和福特CCH周期之后。如果在第2周期之后，曲率没有改善，或阴茎曲率明显改善，患者很高兴，未建议进一步治疗.然而,如果阴茎曲率明显改善，患者仍然不满意，完成4个周期。评估了三类反应：改善（≥10度或≥20％，1发生)，不变(±10度或±20%)或恶化(≥10度或≥20%,1发生）。进行Logistic回归分析以评估与阴茎曲率改善相关的预测因素。
曲率的程度在基线和CCH循环之后变化。
共有114名患者接受了CCH治疗。年龄中位数为57岁。中位PD持续时间为11个月。在基线,平均曲率为47度，65%有背侧弯曲，53%的中轴位置,和15%的钙化。CCH处理后，平均最终曲率为40度。总共44％的改善了曲率，在CCH治疗后，39%没有变化，而17%恶化。在CCH治疗下阴茎弯曲改善的男性中，平均曲率减小的度数和百分比分别为22度和41%，分别。基线曲率≤30、31-59和≥60度的男性，曲率改善的百分比为29%，43%,60%,分别。基线曲率是CCH后阴茎曲率改善的唯一显著预测因素(OR1.33,95%CI=1.1,1.7)。
我们确认基线阴茎曲率是最重要的预测因素，这是第一份描述CCH治疗阴茎曲率改善比例的报告。
这项研究有几个优点，包括使用经过验证的仪器。尽管如此，有局限性：研究的回顾性性质，一个单一的机构；建模设备没有受到控制。
阴茎曲率改善在基线曲率较大的患者中更为常见，对于≥60度的患者，最高可达60%。FloresJM,纳西门托B,旁遮尼N,etal.皮罗尼病患者体内胶原酶组织溶梭菌治疗的曲率改善的预测因子。JSexMed2022；19：1680-1686。
